C. pylori is a recently described bacterium found to cause chronic histological gastritis. Its causal role in peptic ulceration is less clear and even less so in non-ulcer dyspepsia. Its role could be more effectively studied if effective therapy for its eradication were devised.
Until recent times, C. pylori has been found to be difficult to eradicate using known chemotherapeutic agents. Although many antibiotics can suppress C. pylori growth in vitro, in vivo the mucosal concentration appears to be inadequate and penetration of the usual gastric mucus layer poor. Hence, development of an adequate in vivo eradication method for chronic C. pylori infection has been difficult. Moreover, adequate prediction of in vivo results cannot be predicted from in vitro work.
European Patent Application No. 206,625 and Australian Patent Application No. 59026/86 describe the use of bismuth together with a single antibiotic for the treatment of C. pylori. However, bismuth alone achieves low (30 to 70%) initial clearance rates for C. pylori and recurrence of the infection approaches 100% by twelve months post therapy. Bismuth together with a single antibiotic, namely amoxicillin, appears to be relatively effective as a short term means of reducing the symptoms but it is now clear that the use of bismuth together with a single antibiotic frequently fails to eradicate the infection and has a high rate of infection recurrence (Rauws, Erik A. J. et al: Gastro-enterology, 1988; 94: 33-40).